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Diagnosis of Epilepsy

[11 Feb 2012 | No Comments | | Author: ]
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Epilepsy, or seizures, are the outward sign of a malfunction in the electrical system that controls the brain. A single feature can have many causes. Sometimes high temperatures, a lack of oxygen or poisoning can cause a single seizure in an infant or child. However seizures that happen more than once and without any special cause are called epilepsy.

The seizure can come in many different forms. They can be convulsions, brief stares, muscle spasms, odd sensations or even episodes of automatic behavior and altered consciousness. If you have had a seizure you must seek medical help. Your physician will have several questions that you should come prepared to answer. These questions will cover information about how and when the seizure started and what may have prompted it, if the seizure was caused by a short-term problem such as a fever or infection or has this been a continuing problem in the way that the brain’s electrical system is working.

Your physician or healthcare practitioner will also question if there is anything about the structure of your individual brain that could be causing these seizures or was the seizure an isolated event meaning that you do not have epilepsy.

There are several tools that your physician will use when diagnosing epilepsy. The first one is a very careful and thorough medical history where they will ascertain as much information as possible about what the seizure looked like and what happened just before the seizure happened. Your physician will also want to know any other past medical history that would be pertinent to determining if this is an isolated incident or the initial stages of epilepsy.

Following a medical history the doctor will also perform a thorough physical examination, especially of the nervous system. This will involve several different neurological tests that can be accomplished in the physician’s office as well as testing that must be done in a laboratory. The doctor may also want an analysis of blood and other bodily fluids looking for reasons of the seizure activities such as poisons or subclinical infections.

If an obvious answer to the seizure activity is not found immediately the physician will order two separate sets of tests. The first will be computerized tomography or C. T. or a magnetic resonance imaging scan which are used to look for any growths, scars or structural changes or differences in the brain that may be responsible for the seizure activity.

The second test will be an EEG or electroencephalograph which is a machine that records brain wave activity. Tiny wires are attached to an individual’s head and the electrical signals which come from the brain cells are recorded as wavy lines by a machine. These brain waves changed drastically right before and during seizure activity. In some instances individuals may also have brain wave activity which is different between seizures as well.

The EEG is the most important clinical tool used by the physician in evaluating patients who have suspected seizure activity. This influential tool provides a record of ongoing electrical activity and will easily show excessive discharge or excessive electrical activity in the brain that are unique to particular forms of epilepsy.

The EEG recordings are made while a patient is awake with the eyes open and with the eyes closed. If during this EEG abnormal readings are not recorded and the physician still believes that seizure activity is the probable cause for the behavior of the individual, then an EEG will be ordered over a 24-hour period of time. This EEG monitoring is portable and patients are allowed to go home attached to the monitor operating under their own normal daily activities.

During this EEG monitoring doctors will be looking for brain wave activity that is common for the different and specific types of seizure activity that has been recorded in the past. This includes general convulsions as well as olefactory and visual auras.

At least 50 percent of people who have seizure activity will have idiopathic epilepsy meaning that no underlying causes for the activity can be found. Although finding a cause is significant in determining whether or not a cure is possible it is also important to understand the specific type of brain wave activity that happens with the seizures in order to more appropriately treat the seizure activity


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